Sociodemographic factors but not food pouch usage associated with early childhood caries in New Zealand children: Young Foods New Zealand study

Objective: To describe predictors of early childhood caries (ECC, i.e. tooth decay in primary teeth) in toddlers and preschoolers. Design: The Young Foods New Zealand study was a cross-sectional observational study, including a questionnaire for sociodemographic information, oral hygiene practices, and feeding practices, such as food pouch use; measurement of anthropometry; nutrient intake from two 24-hour dietary recalls; and ECC status from dental photographs. Differences between caries-free and caries-positive children were estimated using regression analysis, adjusted for age. Setting: Community study, New Zealand. Participants: 259 children aged 1.0 to 3.9 years. Results: In total, 13.9% of children had ECC. Having ECC was associated with child and carer ethnicity, carer education, childcare use, and current breastfeeding status. Food pouch use, direct feeding from a food pouch nozzle, and weight status were not significantly associated with ECC status. Nutrient intakes were similar in those with and without ECC, including sugars intake. Caries-positive children had lower mean vitamin A (432 vs 526 µg, p=0.004) and marginally lower calcium (634 vs 715 mg, p=0.072) intake, compared to caries-free children, but were at no greater risk of inadequate intake. Conclusions: ECC status was associated with demographic characteristics but not current use of food pouches, in contrast to expectations that pouch use may adversely impact child dental health through exposure to sugary foods. Children with ECC largely met nutritional requirements but had lower vitamin A and calcium intakes.